This volume constitutes the papers and discussions from a symposium on "Societal Risk Assessment: How Safe is Safe Enough?" held at the General Motors Research Laboratories on October 8-9, 1979. This symposium was the twenty-fourth in an annual series sponsored by the Research Laboratories. Initi ated in 1957, these symposia have as their objective the promotion of the interchange ofknowledge among specialists from many allied disciplines in rapidly developing or changing areas ofscience or technology. Attendees characteristically represent the academic, government, and industrial institutions that are noted for their ongoing activities in the particular area of interest. The objective of this symposium was to develop a balanced view of the current status of societal risk assessment's role in the public policy process and then to establish, if possible, future directions of research. Accordingly, the symposium was structured in two dimensions; certainty versus uncertainty and the subjective versus the objective. Furthermore, people representing extremely diverse discip lines concerned with the perception, quantification, and abatement of risks were brought together to provide an environment that stimulated the exchange of ideas and experiences. The keys to this exchange were the invited papers, arranged into four symposium sessions. These papers appear in this volume in the order of their presentation. The discussions that in turn followed from the papers are also included.

A gripping exploration of a jury's members' perspectives on the most wrenching decision: the death sentence With a life in the balance, a jury convicts a man of murder and now has to decide whether he should be put to death. Twelve people now face a momentous choice. Bringing drama to life, A Life and Death Decision gives unique insight into how a jury deliberates. We feel the passions, anger, and despair as the jurors grapple with legal, moral, and personal dilemmas. The jurors' voices are compelling. From the idealist to the "holdout," the individual stories—of how and why they voted for life or death—drive the narrative. The reader is right there siding with one or another juror in this riveting read. From movies to novels to television, juries fascinate. Focusing on a single case, Sundby sheds light on broader issues, including the roles of race, class, and gender in the justice system. With death penalty cases consistently in the news, this is an important window on how real jurors deliberate about a pressing national issue.

Integrating theory with case studies, this book examines the practical application of moral theory in clinical decision-making through 40 composite cases based on actual clinical experience. Complex, realistic, and challenging, these examples contain the multiplicity of factors faced in clinical crises, making this a superb exploration of the ways in which theory relates to actual life-or-death situations.

Seven in ten Americans over the age of age of sixty who require medical decisions in the final days of their life lack the capacity to make them. For many of us, our biggest, life-and-death decisions—literally—will therefore be made by someone else. They will decide whether we live or die; between long life and quality of life; whether we receive heroic interventions in our final hours; and whether we die in a hospital or at home. They will determine whether our wishes are honored and choose between fidelity to our interests and what is best for themselves or others. Yet despite their critical role, we know remarkably little about how our loved ones decide for us. Speaking for the Dying tells their story, drawing on daily observations over more than two years in two intensive care units in a diverse urban hospital. From bedsides, hallways, and conference rooms, you will hear, in their own words, how physicians really talk to families and how they respond. You will see how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result. Research has consistently found that choosing life or death for another is one of the most difficult decisions anyone can face, sometimes haunting families for decades. This book shines a bright light on a role few of us will escape and offers steps that patients and loved ones, health care providers, lawyers, and policymakers could undertake before it is too late.

Experts analyze death-related issues and policies in twelve countries, discussing health care costs, advance directives, pain management, cultural, social, and religious factors, and other topics.

Questions that face dying individuals, their families, and the professionals that help them at the end of their lives are explored in this volume. The contributors help the reader to come to terms with issues of mortality complicated by the diversity of cultures within society.

Decision Making near the End of Life provides a comprehensive overview of the recent developments that have impacted decision-making processes within the field of end-of-life care. The most current developments in all aspects of major underlying issues such as public attitudes, the impact of media, bioethics, and legal precedent provide the background information for the text. The authors examine various aspects of end-of-life choices and decision-making, including communication (between and among family, medical personnel, the dying person), advance directives, and the emergence of hospice and palliative care institutions. The book also explores a variety of psychosocial considerations that arise in decision-making, including religion/spirituality, family caregiving, disenfranchised and diverse groups, and the psychological and psychiatric problems that can impact both the dying person and loved ones. Case studies and first-person stories about decision-making, written by professionals in the field, bring a uniquely personal touch to this valuable text.